We report a patient with neurosarcoidosis, which developed 22 years after augmentation mammoplasty by the injection of silicone gel. She presented with bilateral hilar lymphadenopathy, left-sided lower cranial nerve palsies (8th, 9th, and 10th), and vestibular ataxia, which improved following the administration of prednisolone. Biopsy of the breast nodules showed granulomatous changes identical with those of sarcoidosis, while infrared spectrophotometry disclosed that the nodules contained polydimethylsiloxane, a major component of the silicone gel injection. This is the first report of neurosarcoidosis following silicone mammoplasty.